Mind matters

16th October 2009 at 01:00
Pupils with mental health problems might not always carry a statement of special needs, but their welfare still needs to be handled carefully

Craft sessions, student leaders and staff training are all part of Plashet School's open and holistic approach to mental health and emotional well-being.

"We see our role as overcoming the barriers to learning for our students, whatever these are," explains Stephanie George, the manager of Plashet's learning support unit (LSU), which co-ordinates the school's response to pupils who have mental health problems. Barriers range from poor study skills to fractured friendships. And when pupils feel that they're on the outside, this can lead to depression.

Part of the LSU's remit at this 1,300-strong girls' school in London's East End is providing information on mental health issues for staff and pupils. Plashet's student leaders, 50 pupils who provide mentoring and support for other students, recently helped youth mental health charity Young Minds to run a stall there during Healthy Schools Week.

But not all schools are as eager or well equipped to deal with the rising levels of emotional distress in children and young people.

Despite a spate of Government initiatives to encourage closer working between schools and outside agencies such as the Child and Adolescent Mental Health Service (CAMHS), a recent survey by the Association of Teachers and Lecturers found that almost half of school staff felt that the services to help children with emotional problems were not sufficiently joined up. Staff criticised the excessive bureaucracy when they tried to refer children for help.

A national survey of CAMHS provision, published less than a year ago, stated that, although support for children had improved, there was still "unhelpful tension between services, disjointed support for children, young people and families and missed opportunities".

It noted that schools wanted to develop a greater understanding of mental health issues and to work with CAMHS, but long waiting lists for treatment, mismatching of expectations and the need for CAMHS to focus on individual clinical work often left schools feeling isolated. In another survey of mental health in schools published last month, one of the main challenges schools faced was obtaining specialist advice on the new Targeted Mental Health in Schools initiatives, which aim to provide support for five to 13-year-olds.

Unlike a pupil on the autistic spectrum or someone with a physical disability, a child with depression, bi-polar disorder or anorexia or who self-harms wouldn't necessarily have a statement of special need, which can make dealing with mental health issues a grey area.

Training and help for school staff is still patchy, according to Roger Catchpole, head of training at Young Minds. "Often school staff are left feeling the support isn't out there," he says. "In the end, there is also a limit to what training can do if specialist services aren't available when they're needed."

Yet pupils with mental health difficulties confirm that teachers have a vital role to play in their psychological well-being. The CAMHS survey showed that children and teenagers valued and trusted teachers and would turn to them when they needed help.

Claire, 18, who suffers from depression and obsessive compulsive disorder, told TES Magazine: "My PE teacher noticed I was not my usual self and told me I could come and talk to her any time. When I spoke to her, I felt she was listening and really cared about what I was saying. She didn't panic. She told me she would sort it out and get me some help."

Emma, a university student who had depression and self-harmed as a sixth former, experienced both positive and negative reactions from staff at her school. "My head of year showed her concern and gave me time to talk," Emma says. "She had been on a course about self-harm and wasn't shocked. Other staff weren't so helpful."

Making mental health part of an holistic approach to well-being can help take away some of the stigma, as was the case at Plashet School. "Mental health issues seem less scary when they're seen as part of the Healthy Schools initiative," says Ms George. "We showed a Samaritans film about self-harm. Afterwards, girls spoke about how the issues affected them. They realised that it was OK to talk to someone in school."

Plashet's LSU also has DVDs, books, articles and leaflets about mental and emotional health while the school counsellor, nurse and LSU team have all been involved in staff training on mental health. Student leaders receive training in confidentiality, leadership and peer mediation. One student, a young carer who had become depressed, is now supporting others in the group.

"The student leaders have a sisterly role and they have their fingers on the pulse," says Ms George. "They are often able to defuse a situation or to tell us when there is a problem."

Wherever possible, the school tries to head off problems before they occur. One of the risk factors for mental health difficulties is chronic illness. Recently, a girl who had been away from school for months with eczema received help to re-integrate at school, including a `buddy' who visited her regularly at home.

Projects such as these work well, but the tension between pressure to perform and pupils' emotional well-being adds to the strain on schools, according to Martin Ward, deputy general secretary of the Association of School and College Leaders. "We are never going to have high standards of academic performance if pupils are stressed out," he said. "Yet young people and their teachers are under more pressure than ever."

Mr Ward is also concerned at the lack of resources available to schools to promote mental health. "Schools mostly can't afford to employ their own expert staff," he says.

This was the case at Swanwick Hall School in Derbyshire, where limited funds forced the school to terminate the contracts of two valued counsellors employed though a local voluntary organisation, even though the school has recently won praise from Ofsted for its well-co-ordinated support for students.

But seeking out the right funding and developing an open relationship with local service providers can reap rewards.

A grant from the Devonport Regeneration Company allowed Stoke Damerel Community College in Plymouth to fund a primary mental health worker (PMHW) for sixth formers.

The PMHW, Cindy Willcocks, started by chatting informally to students in their common room, gradually moving on to designing posters with them about mental health and finally to individual support.

"It has had an amazing impact on us," says Julie Bevan, the head of sixth form. "It's destroyed the stigma of admitting to mental health difficulties and early identification of students' difficulties has been key in offering them the right support."

Some sixth formers are taking a counselling course provided by a local mental health charity, which rewards participants with a certificate in mental health awareness. Stoke Damerel is also going to use a mental health worker to work with the whole school.

Ms Willcocks' job is part of a drive by NHS Plymouth to make CAMHS more accessible to young people, their families and schools. Teachers can phone the mental health teams if they are worried about a pupil, they provide training for learning mentors in schools and they can give specialist help to pupils. Additionally, Plymouth CAMHS is developing an outreach team that will respond to concerns about young people within 24 hours.

Building an effective response to young people's mental health issues is part of teaching problem-solving and social skills that will develop emotional resilience in children, helping them to withstand turmoil in their lives.

But to do this, Roger Catchpole of Young Minds believes that comprehensive training is essential. All initial teacher training courses should include a thorough grounding in children's psychological and emotional development and school training should involve everyone, from senior managers to lunchtime supervisors.

"The goal is not about turning school staff into mental health experts," he says. "It's about raising awareness to the level where schools are able to promote mental health and emotional well-being, identify children with additional needs and work with agencies to meet them."

Despite the current harsh economic climate, schools should not ignore training in this area, Mr Catchpole argues. "If expediency leads us to turn our backs on what we know works, the capacity for children, families and professionals to cope with emotional difficulties is likely to become increasingly depleted," he says. " Schools could turn out to be pretty scary places for all concerned."



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